Call Us: 212.729.3922 Book Now Billing First Name (required) Last Name Your Email (required) May we add you to the newsletter? yesno Phone Number Please indicate if you would like Dr. Carmichael to follow up with you regarding: (Check all that apply) Anger ManagementAnxietyGroups for SinglesDepressionExecutive CoachingGroups for BreakupsSelf EsteemSessions by SkypeSocial Anxiety GroupThera-CoachingDating & RelationshipsStress Relief WorkshopStress ManagementPhobiasGoal Attainment Group Please Enter Your Comments or Questions : Please understand that whenever information is transmitted online, there is a chance that the data will be compromised. This form is not encrypted and it is not HIPAA-compliant, so please do not disclose any information that you consider to be sensitve and confidentrial until you are in a private consultation. If you prefer not to transmit information online, simply call Dr. Carmichael at 212-729-3922. If you are at risk of harming yourself or someone else, please call 911 or go to your nearest emergency room. Dr. Carmichael does not specialize in clients who are at risk of self harm. Please remember, your safety is always the first priority, so if you are having thoughts of harming yourself or someone else, please call 911 or go to your nearest emergency room. Otherwise please leave a message and Dr. Carmichael will contact you soon. Please indicate that you have read this message by entering your full name below. Thank you, and looking forward to speaking soon! Contact You may also call 212.729.3922 We’d like to hear from you! Participate in this short survey about Group Therapy at Carmichael Psychology.